Emphysema is a chronic respiratory condition most often caused by the destruction of lung tissue by toxins contained in cigarette smoke. This in turn leads to chronic overinflation of the lungs, greatly decreasing their ability to function.
Like chronic bronchitis, emphysema is a chronic obstructive pulmonary disease (COPD) that evolves over a period of time. Emphysema results in destruction of the alveoli, the tiny air sacs in the lungs. Oxygen is delivered to the lungs and carbon dioxide is carried from the lungs across the walls of the alveoli. As more and more alveoli are damaged, it becomes harder and harder for the lungs to function, which can cause these symptoms:
As the disease progresses, breathing becomes increasingly difficult. In its most severe stage, virtually any physical activity becomes extremely difficult, if not impossible.
According to Dr. Joseph Zibrack, associate director of pulmonary and critical care medicine at Boston's Beth Israel Deaconess Medical Center, "Like chronic bronchitis, over 90% of all cases of emphysema are caused by long-term smoking of cigarettes or other tobacco products. [In rare cases], emphysema is inherited and results from a deficiency of a protein known as alpha-1 proteinase inhibitor (alpha-1)."
When a patient complains of the chronic presence of the symptoms of emphysema, a physical exam and various lung capacity tests are done to confirm the diagnosis. Chest x-rays may also be done.
Since, at present, emphysema cannot be cured, the goals of treatment are to:
To relieve symptoms, one or more of the following treatments may be used:
Emphysema may also be treated with surgery, such as:
To slow emphysema's progression, the agent causing it must be removed. And since long-term smoking causes the overwhelming number of cases of emphysema, the only effective way to slow the progression of emphysema is to quit smoking.
To prevent the onset (or worsening) of emphysema, take the following steps:
Emphysema does not suddenly occur. It develops over a long period of time. Unfortunately, many sufferers ignore their condition until it becomes serious, at which point treatment options are less effective. Therefore, at the first sign of any of the symptoms, talk to your doctor.
DynaMed editorial team. COPD. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated June 30, 2010. Accessed July 7, 2010.
Health Library editorial staff and contributors. Emphysema. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated May 24, 2010. Accessed July 7, 2010.
Tutic M, Lardinois D, Imfeld S, Korom S, Boehler A, Speich R, et al. Lung-volume reduction surgery as an alternative or bridging procedure to lung transplantation. Ann Thorac Surg . 2006 Jul;82(1):208-13.
Last reviewed July 2010 by Brian Randall, MD
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